Schlüsselwörter

Abduzensparalyse Botulinumtoxin Jenson-OP

Bilateral post-traumatic VI nerve paralysis

Summary

We present a female 56-year-old patient with bilateral VI nerve palsy after a serious motorcycle accident. The patient received 10 units of botulinumtoxin (Dysport®) in the first three months, twice into the m. rectus medialis in both eyes for contraction avoidance. Motility was clinically unchanged after injection. A Jensen procedure on both eyes at the same time was carried out five months after the accident. The recession of the medial rectus on both sides was not necessary as the intraoperative forced duction test revealed no limitation. The bilateral consecutive adduction deficit postoperative was mainly botulinumtoxin-induced, two months postoperatively there was a marked improvement in the exotropic deviation. Six months postoperatively, the patient had regained stereosis without head tilt.

Spontaneous remission of bilateral post-traumatic VI nerve palsy is rare. For quick rehabilitation, a bilateral Jensen procedure after botulinumtoxin injection in both medial recti is a good option to reduce the number of muscles that must be operated upon.